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17D-056 (4) PERMIT APPLICATION CHECK LIST PA ZON YES NO DATE MN 1 . I 3 . OWNER OCCUPANT STAT MENT IF NOT 4 . 3 SETS OF PLANS /PLOT PLAI 5 . NEW CONSTRUCTION 6 . CURB CU 7 . WATER AVAILABILITY FORMS 8 . REMODELING INTERIOR 9 . ADDITIO 10 . ACCESSORY STRUCTURE 11 . SIGN W I 12 . PERMIT FE - 111M NLY - MONEY ORDER 13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE 14 . UNDER SECTION 127 - CMR 780 15 . FORM A 16 . FILL COMMENTS : =WPM", > > 7 > Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations NORTHAMPTON, MASS. 19— Additions APPLICATION FOR PERMIT TO ALTER Repair a Garage 1. Location . 2,-n-et S Lot No. 2. Owner's name Address V A 3. Builder's name Address: -/J Mass.Construction Supervisor's License No. I 9r� Expiration Date 4. Addition 5. Alteration 6. New Porch 7. Is existing building to be demolished? 8. Repair after the fire 9. Garage No.of cars Size 10. Method of heating 11. Distance to lot lines 12. Type of roof 3L1;4)A44W- 13. Siding house 14. EstimatedCOSL- The undersigned certifies that the above statements are true to the best of his, her knowledge and belief. Signature of respons�ble app icam Remarks . .rives Date Filed File No. ZONING PERMIT APPLICATION (Sib. 2) 1 . Name of Applicant: Address : L fir' Telephone: Sty 2 . Owner of Property: - Address : / Telephone: 3 . Status of Applicant: Owner Contract Purchaser Lessee Other (explain: ) i71D 4 . Parcel Identification: Zoning Map Sheet# 0#0 Rarcelf , Zoning District(s) (inclu overlays) Street Address Required 5 • ZExistingPro osed by Z nin Use of Structure/Property (if project is only interior work, skip to #6) Building height %B1dg. Coverage (Footprint) Setbacks - front - side L: L: R: - rear Lot size Frontage Floor Area Ratio %Open Space (Lot area minus building and parking) Parking Spaces Loading Signs Fill (volume & location) 6 . Narrative Description of Proposed Wo k/Project: (Use additional sheets if necessary) 7 . Attached Plans: Sketch Plan Site Plan 8 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. Date: A p p 1 i c a n t r s Signature ZApproved THIS SECTION FOR OF UE FICIAL S ONLY:as presented/based on information presented Denied as presented--Reason: Special' Permit and/or Site Plan Required: nding Re •r d• Variance Required: ` ' A' 4cgrnatur/e' Buy or D e 1`7 NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning roquiroments and obtain all required permits from tho Board of Health, conservation commission, Dopattmont of Public Works and othor applicable pormh granting authorities. iell_ g�°� � City of Northampton REQUIRED INSPECTIONS e BUILDING DEPARTMENT 1. Footings and Walls 2. Structural Components in Place* 3. Complete Building* No. 851 Office of the Building Inspector Zoning Form No. 002791 Date g/2A/q4 Fee 20 Check# 483 Page, 17D pal 56 ,Zone URB Section 127 ❑ Yes ® No BuiiLDiNG PERmi r * Plumbing and Electrical Inspections required THIS CERTIFIES THAT William Gnatek before Building Inspections has permission to Strip and reshingle roof Inspection on Site--Foundations situated on 12 Verona Street Inspection of Plumbing—Rough provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish conform to the terms of the application on file in this office, and to the Gas Inspection provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring—Rough Maintenance and Inspection of Buildings in the City of Northampton. Any violation of any of the terms above noted is an immediate revocation Inspection of Wiring—Finish of this penmit.Expires six months from date of issuance,if not started. Building Inspection—Rough Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection of this card signed by the Plumbing,Wiring and Building Inspectors. ** Install per Manufacturers information: windows, vinyl siding, Building Inspection—Finish roofs and woodstoves. Smoke Detectors(Fire Department) Other THIS CARD MUST BE DISPLAYED IN A CONSPICU PACE -N PREMISES Certificate of Occupancy -- g Inspector